Comparison of Lateralized Versus Medialized Reverse Total Shoulder Arthroplasty: A Systematic Review and Meta-analysis

Abstract

Background: Reverse total shoulder arthroplasty (rTSA) is an established procedure for cuff tear arthropathy. More lateralized prostheses have been designed to overcome the reported adverse outcomes of Grammont-style rTSA. Purpose: To compare the clinical and radiological outcomes of medialized and lateralized center of rotation (COR) in rTSA. Study Design: Systematic review; Level of evidence, 3. Methods: This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included were studies with a level of evidence ≥3 that compared medialized and lateralized rTSA with a minimum follow-up of 12 months. Functional scores including the American Shoulder and Elbow Surgeons (ASES) score and Constant score (CSS), range of motion at final follow-up, gain of external rotation (ER), visual analog scale (VAS) pain score, scapular notching, and heterotopic ossification (HO) were compared. Data were analyzed using random-effects or fixed-effects models in accordance with heterogeneity. Results: Five retrospective cohort studies and 1 randomized controlled study (n = 594 patients) were included. Lateralized rTSA resulted in greater improvement in ER degree (P